Abc Pediatric Dentistry, LLC

Organization Active NPI Pediatric Dentistry · Gillette, WY

NPI 1972822930 · NPPES record last updated May 28, 2010

Key facts

NPI
1972822930
Entity type
Organization (NPI type 2)
Primary specialty
Pediatric Dentistry 1223P0221X
Legal business name
ABC PEDIATRIC DENTISTRY, LLC
Practice address
610 S 4J CT # B
Gillette, WY 82716-4127
Phone
(801) 842-6971
NPI assigned
May 28, 2010
Organization subpart
No

Authorized official

Name
Dr. Nathan D Stevenson, DDS
Title
Manager
Phone
(801) 842-6971

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223P0221X Yes

Addresses

Primary practice location

610 S 4J CT # B
Gillette, WY 82716-4127

Mailing address

4019 W 12600 S Ste 200
Riverton, UT 84096-7406
Phone (801) 842-6971

Other providers in Gillette, WY

All providers in Gillette, WY · Pediatric Dentistry in Wyoming

Sources for this page

Verify at the official NPI Registry.